Teen Girls, Weight Loss Surgery, Body Image and Class Distinctions

A while back, I watched a documentary titled “Killer at Large
,” which outlined how obesity has been handled in our society and how its affected our children. And within that documentary, the viewing audience was introduced to this young girl:

Meet 12 year old Brooke. A 5’5″ girl who weighed in at 220lbs. After putting on 40lbs in one year, her two slender parents decided it may be time to talk to the doctor about liposuction. In the documentary, you see the doctor cracking jokes about how “usually, when girls step on this scale, they take off their shoes, their earrings, their lipstick [in an effort to weigh less on the scale]” and you see Brooke discussing the downfalls of her added weight. The “smell” that she encounters from her apron. The way she’s known as “the nice girl,” never “the hot girl.”

The documentary takes you deep within the operating room, where the doctor then begins Brooke’s liposuction procedure. A bit of time passes, and then you see the doctor pointing to the giant vials of fat he’s removed from her body, and you hear someone (I believe the doctor) say, “You’ve lost more weight in one day than you’ve lost in your whole life.” Brooke’s father says, “If you kept coming back here, you’d be as skinny as your Mama.” You can see Brooke, still a little drowsy from the anesthesia, smiling and saying “Yup!”

That was 2006. Back then, ABC News wrote the following (important parts are in bold):

After watching a documentary on weight loss, 12-year-old Brooke decided on liposuction, a procedure thought to sculpt an imperfect body, not treat obesity.

She went to see Dr. Robert Ersek, a leading plastic surgeon in Austin. […] Brooke’s interview with Ersek before surgery shed light on her fears and her hopes for a normal future.

“Maybe If I could do it I would look a little normal,” she told him.

Not only was the extra weight affecting Brooke’s self-esteem, but it was seriously affecting her health.

Her mother, Cindy, said that Brooke’s blood pressure was sky high, and doctors said she was at risk for a stroke. [source]

Keep the bold in mind. And remember.. that was 2006.

Fast forward to 2007 – only seven months later – where Brooke, now 13, regained 35 of those pounds. Again, ABC News reported the following:

Brooke said she has always struggled with her weight. At her heaviest, she weighed 220 pounds. By early 2006 she lost 40 pounds through liposuction and a tummy tuck. But, in less than a year, she regained 35 pounds.

After the liposuction and tummy tuck, which cost $25,000, Brooke said she “went from the big, fat girl to the popular girl.”

“Then I gained weight back and it was depressing,” Brooke said. “But now that I had the lap band done, everything is just working out great.”

[…]

Brooke’s mother, Cindy Bates, said she was sad for Brooke when she began gaining weight after her first round of surgeries, but she said she didn’t blame her daughter.

“It was the happiest year of her life and it was sad watching her, you know, struggle with trying to keep the weight off,” Cindy said. “So that’s the reason we did the lap band so she could control her hunger and how much food intake she was putting in her body every day.”

Most doctors in the United States usually don’t perform gastric lap-band surgery unless a patient is at least 18 years old, has a body mass index of 40 or higher or weighs at least twice his or her ideal weight.

So against the advice of their family doctor, the Bates traveled to Mexico to get the procedure done, without trying to find a local surgeon. The procedure cost $7,900.

From the same article, one more gem:

While Brooke likened her overeating to an addiction, her mother said that she didn’t believe the problem was psychological.

“I don’t really relate it to an emotional issue,” Cindy said. “I think it’s more of a hereditary characteristic in our family.” [source]

Now… this all happened in 2007. Fast forward to like… ten days ago:

A type of weight-loss surgery not approved for adolescents is becoming more and more common among teens in California, according to a report published today. Most of the patients are white girls, although they make up less than half of overweight youth, researchers say.

From 2005 to 2007, they found rates of so-called gastric banding, in which a silicone band is placed around the top portion of the stomach to restrict food intake, rose five-fold. However, use of gastric bypass — which surgically reduces the size of the stomach — dropped, leaving the overall rate of weight-loss procedures constant.

Despite not being approved by the Food and Drug Administration for use in adolescents younger than age 18, gastric banding overtook gastric bypass as the most frequently performed weight-loss procedure in this age group, Dr. Daniel DeUgarte and colleagues from the University of California, Los Angeles, report in the journal Pediatrics.

[…]Among the 590 California youths between 13 and 20 years of age who underwent weight-loss procedures over three years, no one died and the rate of in-hospital complications were comparable at less than six percent.

[…]While white people account for just over a quarter of overweight adolescents in California, they made up about two-thirds of those who had surgery. There could be many reasons for these findings, according to the researchers, who note that only severely obese people who have failed diet and exercise programs are considered for weight-loss surgery.

“I do think that has something to do with the difference between male and female body image perception,” said Dr. Marc P. Michalsky, surgical director for the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital in Columbus, Ohio, who was not involved in the research.

But, he added, “We try very, very hard to dispel any notion that this is a cosmetic procedure.”

Michalsky said he wasn’t surprised by the new findings, but noted that solid evidence for gastric banding has yet to be produced.

“Why do we feel it is necessary to operate on a bunch of 15-year-olds?” he told Reuters Health. “The theory is, and we have yet to prove this, that early intervention will result in a substantial difference in the outcomes regarding obesity-related diseases,” such as diabetes and heart disease.

While weight-loss surgery may cost up to $50,000, for some individuals, he said, it appears to be the only way to achieve durable results. [source]

I have so many questions. I don’t even know where to begin. Wait, yes I do.

“Not only was the extra weight affecting Brooke’s self-esteem, but it was seriously affecting her health. Her mother, Cindy, said that Brooke’s blood pressure was sky high, and doctors said she was at risk for a stroke.” Was it not the duty of her doctor to tell her that this is not a causal relationship? High blood pressure isn’t caused by “being fat.” Both high blood pressure and “being fat” are caused by unhealthy food. I imagine Brooke finally learned this lesson after her surgery, though.

What is going on in that home where there’s so much focus on “looking normal” as opposed to embracing who she is? It’s one thing to want to work on yourself, but it is another thing entirely to think you need work because you are less than. The jokes the Father and the doctor made after the young girl’s surgery? C’mon, man. I already know why no one taught her to embrace who she is. They were just as disgusted by her as her peers proclaimed to be… and caused Brooke to develop that very same disgust for herself, as evidenced by her interviews… which leads me to my next question.

The girl gained back 35 of the 40lbs she had sucked out through lipo. Thirty-five. Of forty. 87.5%. Her parents paid $25,000 for Brooke to lose 5lbs, basically. After all of that, the Mother still has the audacity to say, “I don’t really relate it to an emotional issue.” [insert blank stare] Let’s think about this. You endure an invasive procedure to lose weight. You, essentially, get “everything you wanted” because all the little girl wanted was “to look normal,” and then you sabotage it by gaining back all but five pounds. That doesn’t appear to have a psychological issue attached to it? I remember seeing the Mom answer that question – her answer felt more like she was trying to avoid an attack on her parenting than actually interested in a conversation on the well-being of her child. Take it a step back – Brooke, herself, said that her overeating was an addiction. How on Earth did the Mom presume that’s not emotional?

Now, when I first saw this story, I was mortified. The documentary showed Brooke discussing how she realized she was an emotional eater — that she’d react to her parents’ fights by stuffing herself to make herself feel better (which lets me know that her parents would rather spend several thousand dollars to make her daughter “look okay” by way of liposuction than buy non-processed foods, but I digress) and was really sad about the way she had “let herself go.” The entire process matured her, but I still lament the fact that she grew up with placing her self-worth in her body.. something that young girls suffer from in ways we don’t like to imagine.

During the same time frame, approximately 600 teens in California underwent some form of weight loss procedure. Since California is a state with one of the ten best obesity rates in the nation (24.8%), I’m quite surprised to read that “While white people account for just over a quarter of overweight adolescents in California, they made up about two-thirds of those who had surgery.”

There is something so very wrong with this. Let’s face it – America likes “easy answers” and regardless of whatever post-surgery complications one faces with weight loss surgery, the reality is that the problem as America sees it (read: the weight) is gone. If the non-whites in California could afford to free themselves of the social stigma of weight… wouldn’t they? Brooke’s family paid to rid Brooke of her “problem” twice. They even travelled to Mexico to handle “it.” So again, the difference between the overweight and the thin? Money. Money, money, money. This isn’t even about food at this point… and it certainly isn’t about health. Is this why we keep assuming that those who are fat obviously don’t have any money? Because, well, if they did, they’d pay to get rid of “all that?” Sigh.

The last question I have, involves the following:

“The theory is, and we have yet to prove this, that early intervention will result in a substantial difference in the outcomes regarding obesity-related diseases,”

Early intervention into what? Into what, exactly, are you intervening? Weight gain? Does weight loss surgery performed on someone who isn’t even fully capable of understanding the consequences magically stop weight from being added? Does weight loss surgery magically unclog arteries? Does it insert a chip into your brain to cause you to eat in a fashion that prevents you from gaining weight in the first place? Or does it even place a little tiny fairy on your shoulder to tell you “Ahh, ahh, ahh, you shouldn’t be eating that?” Didn’t we learn anything from Brooke?

That 12 year old girl teaches us a powerful lesson – regardless of how you lose the weight, if you don’t have a plan in action to work to help you keep it off and prevent yourself from gaining every again… then guess what? You’re going to wind up right back where you started. Do yourself a favor and get it right the first time.